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Project Type
UX Research, Mixed Method 

Duration
1.5 months

Role
UX Researcher and Designer

Tool
Google Form, Excel, Adobe Illustrator and Photoshop
Overview

In collaboration with a local hospital's intensive care unit (ICU) department, this DFA project aimed to enhance the patient experience. My role involved identifying challenges and understanding the patient's perspective within the ICU environment. Through a range of user research methods, including surveys, observations, interviews, contextual inquiries, and co-design workshops, we gained valuable insights from three distinct stakeholder groups in the ICU. While the project was unable to proceed to the prototyping stage due to the pandemic, the research findings provided the ICU department with a comprehensive understanding of the challenges faced by patients in their ICU experience.




About the Project


The ICU is a very emotionally charged space that can result in traumatizing experiences for patients and visitors of patients alike. Additionally, caretakers and practitioners that navigate this space become so desensitized to the experience that it is difficult for them to empathize with the distressed visitors.

In this project, our team aims to improve the patient experience in the ICU environment. We seek to understand the challenges faced by patients and analyze their relationship with medical professionals. Then we propose strategies that foster a patient-centered experience.

HMW Questions:
  • How might we build trust and understanding between patients and ICU staff, enabling patients to focus on their recovery?
  • How might we encourage medical professionals to prioritize patient-centered care in the ICU?




Team


Our team was a group of Brown & RISD students, and superviosrs affiliated with Design For America





Method


The mixed method approach was selected to cater to different stakeholder groups. Quantitative data enabled our team to gain a comprehensive understanding of patients' perspectives on the ICU experience, while qualitative data allowed us to delved deeper into their feelings and challenges in ICU environment of our client.






User Segmentation 


Who is in the problem space? Understanding the key stakeholders in the ICU setting is crucial, as patients, often in a passive state, heavily rely on human interactions within this space. Initially, we identified two primary actors: patients and medical professionals. However, our research revealed two important considerations. First, many ICU patients face challenges in communication, leading us to include their family members or caretakers within the patient group to represent their perspectives and experiences. Second, the broad categorization of "medical professionals" proved insufficient, as doctors and nurses different workflows and interactions with patients during our observations. Thus, we divided the medical professionals into doctors and nurses, resulting in three finalized stakeholder groups: patient&family, doctors, and nurses.




Testing & Analysis


Interview
To kick off, we interviewed 5 patients/caregivers and 9 ICU staffs (physicians and nurses). For patients and caregivers, we aimed to understand their general thoughts on ICU experience. Therefore, we focused on asking how patients and caregivers describe their experience and struggle in ICU, especially related to the interactions with staffs. For healthcare professionals, we wanted to understand how staffs recognize patients’ struggle and situation in ICU environment.


Key findings from thematic analysis

1. Involvement of patient/family is important in patient-staff interaction 

staffs think that giving families some type of control in a patient situation or involving them in the decision-making process is important in building trust and creating better relationships between patient/family and staff.

2. Social worker intervention

there are certain situations in that patients, families and staff feel uncomfortable encountering each other. In these cases, social workers intervene in their interactions to support both sides.

3. Communication as a major challenge

Staffs reveal their struggles with communication, especially the one between staff members. Due to the high-stress environment with a hectic schedule, some communication could fall through the cracks.



Survey
While having interviews, we created online survey to hear more from patients/caregivers. The major purpose of the survey was to understand which stage of ICU experience that patients/caregivers struggle the most and what are some improvements they are expecting. To help participants answer easily, we provided simple patient journey graphics that divided ICU experience into 4 stages (check-in, assessment, treatment, outcome). By doing so, we were able to get more detailed answers from patients/caregivers which helped us define what to ask to ICU staffs in later phases.


Key findings

1. Focus on assessment stage

Assessment stage(running tests and getting asked questions about condition) was the most challenging experience for patients.

2. Staff-patient interactions and patient resources are the key area to improve

Patients/caregivers believe these are the need improvements to make in ICU - shorter waiting time, better communication between patients and staff, increase efficiency for patients in pain, more sympathetic staffs, better acommodations for caregivers.



Shadowing
During shadowing, our team wished to explore the realistic ICU environment and better understand the general workflow and human interactions. Based on the interview and survey data, we decided to focus on three areas during shadowing:

1) interactions between people
2) layout of the space



Key findings

1. Nurses as key stakeholder in staff-patient interaction

Nurses have a broad range of communication including empathetic interactions with patients and caregivers. However, due to patients’ health conditions, most of the communication happened between nurses and caregivers.

2. Lack of communication between nurses and doctors

Due to hectic work shift of nurses, there isn’t enough time for doctors to interact with nurses. They usually communicate through the information on the computers.



Codesign workshop (Participatory)
Based on the survey data, we developed a patient journey map for the ICU. To have more feasible solutions for creating a patient-friendly ICU environment, we organized a co-design ideation session involving 17 doctors from the hospital. During the session, we displayed a new patient journey map on the wall and requested participants to identify potential challenges at each stage of the patient experience using sticky notes. Once all the notes were collected, we analyzed the challenges by identifying patterns through an affinity diagram. Subsequently, we formed four groups and assigned them the task of proposing a solution for the identified problem space within a given time frame.


Key findings

1. Sensory overload

Overload of stimuli during the stay was the major concern that staffs wish to improve for a better ICU experience of patients and their families.

2. Waiting time is the stage to intervene with design solutions

Staffs believe that there are a lot of elements to improve while patients are waiting. For patients/families, providing tools to inform them about patient situations better, allowing patients to feel cared. For staff, creating tools that could reduce tedious responsibilities required in the primary stage to have efficient time managing for patient treatment.



Results




















© Sejin Hwang